Representative Estimates of COVID-19 Infection Fatality Rates from Three Locations in India

AbstractThere are very few estimates of the age-specific infection fatality rate (IFR) of SARS-CoV-2 in low- and middle-income countries. India reports the second highest number of SARS-CoV-2 infections in the world. We estimate age-specific IFR using data from seroprevalence surveys in Mumbai (population 12 million) and Karnataka (population 61 million), and a random sample of economically distressed migrants in Bihar with mortality followup. Among men aged 50–89, IFR is 0.12% in Karnataka (95% C.I. 0.09%–0.15%), 0.53% in Mumbai (0.52%–0.54%), and 5.64% among migrants in Bihar (0–11.16%). IFR in India is approximately twice as high for men as for women, is heterogeneous across contexts, and rises much less at older ages than in comparable studies from high income countries.

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Disability and treatment of specific mental and physical disorders across the world

The British Journal of Psychiatry ◽

10.1192/bjp.bp.107.039107 ◽

2008 ◽

Vol 192 (5) ◽

pp. 368-375 ◽

Cited By ~ 204

Author(s):

Johan Ormel ◽

Maria Petukhova ◽

Somnath Chatterji ◽

Sergio Aguilar-Gaxiola ◽

Jordi Alonso ◽

...

Keyword(s):

Mental Health ◽

Mental Disorders ◽

High Income ◽

World Health ◽

Role Functioning ◽

Middle Income ◽

Middle Income Countries ◽

The World ◽

Physical Disorders ◽

Low And Middle Income

BackgroundAdvocates of expanded mental health treatment assert that mental disorders are as disabling as physical disorders, but little evidence supports this assertion.AimsTo establish the disability and treatment of specific mental and physical disorders in high-income and low- and middle-income countries.MethodCommunity epidemiological surveys were administered in 15 countries through the World Health Organization World Mental Health (WMH) Survey Initiative.ResultsRespondents in both high-income and low- and middle-income countries attributed higher disability to mental disorders than to the commonly occurring physical disorders included in the surveys. This pattern held for all disorders and also for treated disorders. Disaggregation showed that the higher disability of mental than physical disorders was limited to disability in social and personal role functioning, whereas disability in productive role functioning was generally comparable for mental and physical disorders.ConclusionsDespite often higher disability, mental disorders are under-treated compared with physical disorders in both high-income and in low- and middle-income countries.

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Predicted COVID-19 fatality rates based on age, sex, comorbidities and health system capacity

BMJ Global Health ◽

10.1136/bmjgh-2020-003094 ◽

2020 ◽

Vol 5 (9) ◽

pp. e003094 ◽

Cited By ~ 7

Author(s):

Selene Ghisolfi ◽

Ingvild Almås ◽

Justin C Sandefur ◽

Tillman von Carnap ◽

Jesse Heitner ◽

...

Keyword(s):

Health System ◽

High Income ◽

Sub Saharan Africa ◽

System Capacity ◽

Asia Pacific ◽

Fatality Rate ◽

Middle Income ◽

Middle Income Countries ◽

Sub Saharan ◽

Low And Middle Income

Early reports suggest the fatality rate from COVID-19 varies greatly across countries, but non-random testing and incomplete vital registration systems render it impossible to directly estimate the infection fatality rate (IFR) in many low- and middle-income countries. To fill this gap, we estimate the adjustments required to extrapolate estimates of the IFR from high-income to lower-income regions. Accounting for differences in the distribution of age, sex and relevant comorbidities yields substantial differences in the predicted IFR across 21 world regions, ranging from 0.11% in Western Sub-Saharan Africa to 1.07% for high-income Asia Pacific. However, these predictions must be treated as lower bounds in low- and middle-income countries as they are grounded in fatality rates from countries with advanced health systems. To adjust for health system capacity, we incorporate regional differences in the relative odds of infection fatality from childhood respiratory syncytial virus. This adjustment greatly diminishes but does not entirely erase the demography-based advantage predicted in the lowest income settings, with regional estimates of the predicted COVID-19 IFR ranging from 0.37% in Western Sub-Saharan Africa to 1.45% for Eastern Europe.

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P2-457 Trade is associated with the distribution of under, over, and normal weight among adult residents of low-and-middle-income countries: a multilevel analysis using data from the world health surveys

Journal of Epidemiology & Community Health ◽

10.1136/jech.2011.142976l.85 ◽

2011 ◽

Vol 65 (Suppl 1) ◽

pp. A347-A347 ◽

Cited By ~ 1

Author(s):

A. Nandi

Keyword(s):

Multilevel Analysis ◽

Health Surveys ◽

Normal Weight ◽

World Health ◽

Middle Income ◽

Middle Income Countries ◽

The World ◽

Using Data ◽

Low And Middle Income

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Injury Prevention Research and Global Child Health

10.1542/9781610021906-part04-ch19 ◽

2018 ◽

pp. 339-358

Author(s):

Nichole L. Hodges ◽

Gary A. Smith

Keyword(s):

Public Health ◽

Injury Prevention ◽

High Income ◽

Public Health Approach ◽

Unintentional Injuries ◽

Middle Income ◽

Mortality And Morbidity ◽

Middle Income Countries ◽

The World ◽

Low And Middle Income

Injuries are a leading cause of death and disability among children throughout the world. It is estimated that 735,500 children and teens younger than 20 years die from unintentional injuries annually. Although injuries are one of the most common causes of pediatric mortality globally, they do not affect all regions of the world equally. Low- and middle-income countries not only experience pediatric injuries at a much higher rate than high-income countries, but they also have greater total injury-related mortality and morbidity. An estimated 97% of all pediatric unintentional injury-related deaths occur in low-and middle-income countries. This chapter will describe the global public health burden and leading causes of unintentional injuries to children. We will also discuss the application of the public health approach and the principles of injury prevention to child injury. Best practices and case studies will be presented to highlight innovative research studies and evidence-based injury prevention strategies that have been implemented in low-, middle-, and high-income countries. The chapter closes with an overview of current research gaps and suggestions for advancing the field. This chapter will not discuss intentional injury specifically, which, in the editors’ assessment, deserves a detailed and comprehensive thesis— not achievable in a single chapter.

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SIGNIFICANT PREDICTORS OF INTEREST IN GERIATRICS AMONG LOW, MIDDLE, AND HIGH INCOME COUNTRIES

Innovation in Aging ◽

10.1093/geroni/igz038.539 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S150-S150

Author(s):

Grace Karikari ◽

David K Lohrmann ◽

Lesa L Huber

Keyword(s):

Medical Students ◽

Scientific Evidence ◽

The Elderly ◽

High Income ◽

Fiscal Year ◽

Cochrane Library ◽

Middle Income ◽

Middle Income Countries ◽

The World ◽

Low And Middle Income

Abstract Even though the demands for physicians with geriatric related specialties are higher than the available experts around the world, some countries and economies seem to be more impacted by the workforce shortage than others. This systematic review consolidated scientific evidence reporting the significant predictors of interest in pursuing a geriatric career among medical students’ in different countries. A 20-year (1998 – 2018) systematic literature review of high-quality primary research articles was conducted using PubMed, ERIC (EBSCO), Embase and Cochrane Library. Eleven articles (n =11) met the eligibility and quality assessment criteria. For analysis, studies were categorized into (i) low- and middle-income countries and (ii) high income countries, based on the WHO and the World Bank’s income grouping for the 2019 fiscal year. Medical students involved in this review were n = 1,683 representing students from different fields of medicine and year groups. The two most significant predictors of interest in geriatrics in the high-income countries were (1) positive attitudes towards the elderly and (ii) participation in a geriatric related intervention. Lack of published peer-reviewed articles from the low and middle-income countries limited the researchers’ ability to evaluate the similarities and differences between the two income groups. There is an overall need to stimulate interest in geriatric specialization among medical students. Leaders of the LMICs should invest in geriatric education and research in order to promote interest in the field, increase the geriatric workforce, and ultimately, improve the quality of life of the elderly in their respective countries

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Tuberculosis and Non-Communicable Disease Multimorbidity: An Analysis of the World Health Survey in 48 Low- and Middle-Income Countries

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052439 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2439

Author(s):

Brendon Stubbs ◽

Kamran Siddiqi ◽

Helen Elsey ◽

Najma Siddiqi ◽

Ruimin Ma ◽

...

Keyword(s):

Health Survey ◽

Low Income ◽

World Health ◽

Low Income Countries ◽

Multivariable Logistic Regression Analysis ◽

World Health Survey ◽

Middle Income ◽

Middle Income Countries ◽

The World ◽

Low And Middle Income

Tuberculosis (TB) is a leading cause of mortality in low- and middle-income countries (LMICs). TB multimorbidity [TB and ≥1 non-communicable diseases (NCDs)] is common, but studies are sparse. Cross-sectional, community-based data including adults from 21 low-income countries and 27 middle-income countries were utilized from the World Health Survey. Associations between 9 NCDs and TB were assessed with multivariable logistic regression analysis. Years lived with disability (YLDs) were calculated using disability weights provided by the 2017 Global Burden of Disease Study. Eight out of 9 NCDs (all except visual impairment) were associated with TB (odds ratio (OR) ranging from 1.38–4.0). Prevalence of self-reported TB increased linearly with increasing numbers of NCDs. Compared to those with no NCDs, those who had 1, 2, 3, 4, and ≥5 NCDs had 2.61 (95% confidence interval (CI) = 2.14–3.22), 4.71 (95%CI = 3.67–6.11), 6.96 (95%CI = 4.95–9.87), 10.59 (95%CI = 7.10–15.80), and 19.89 (95%CI = 11.13–35.52) times higher odds for TB. Among those with TB, the most prevalent combinations of NCDs were angina and depression, followed by angina and arthritis. For people with TB, the YLDs were three times higher than in people without multimorbidity or TB, and a third of the YLDs were attributable to NCDs. Urgent research to understand, prevent and manage NCDs in people with TB in LMICs is needed.

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Adherence to Food-Based Dietary Guidelines: A Systemic Review of High-Income and Low- and Middle-Income Countries

Nutrients ◽

10.3390/nu13031038 ◽

2021 ◽

Vol 13 (3) ◽

pp. 1038

Author(s):

Ana Carolina B. Leme ◽

Sophia Hou ◽

Regina Mara Fisberg ◽

Mauro Fisberg ◽

Jess Haines

Keyword(s):

English Language ◽

Economic Status ◽

High Income ◽

Dietary Guidelines ◽

Systemic Review ◽

Healthy Children ◽

Future Health ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

Research comparing the adherence to food-based dietary guidelines (FBDGs) across countries with different socio-economic status is lacking, which may be a concern for developing nutrition policies. The aim was to report on the adherence to FBDGs in high-income (HIC) and low-and-middle-income countries (LMIC). A systematic review with searches in six databases was performed up to June 2020. English language articles were included if they investigated a population of healthy children and adults (7–65 years), using an observational or experimental design evaluating adherence to national FBDGs. Findings indicate that almost 40% of populations in both HIC and LMIC do not adhere to their national FBDGs. Fruit and vegetables (FV) were most adhered to and the prevalence of adhering FV guidelines was between 7% to 67.3%. HIC have higher consumption of discretionary foods, while results were mixed for LMIC. Grains and dairy were consumed below recommendations in both HIC and LMIC. Consumption of animal proteins (>30%), particularly red meat, exceeded the recommendations. Individuals from HIC and LMIC may be falling short of at least one dietary recommendation from their country’s guidelines. Future health policies, behavioral-change strategies, and dietary guidelines may consider these results in their development.

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